| NPI | 1245390160 |
|---|---|
| Doing Business As | LAKESIDE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | JOHN WILSON Chief Financial Officer 816-271-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MO MD116083) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-06-30 |